Gynecologic Oncology Fellowship

The Gynecology Oncology fellowship at Cleveland Clinic is a three-year program that accepts it’s trainees following completion of residency from an ACGME approved program.

The primary goal of the fellowship is to provide an in-depth experience in clinical and investigative work to allow pursuit of an academic career within gynecologic oncology. Fellows obtain experience in the basic science laboratory, clinical, research as well as the clinical aspects of gynecologic oncology. The fellows have an intensive and ongoing research experience allowing them to develop quality collaborative research programs during their future careers. The fellows also have an intensive and broad based clinical experience with progressive responsibility resulting in the capability of providing independent subspecialty care within a tertiary medical center.

The major strength of this program is the strong clinical experience gained at our institution renowned for combining patient care, research and education. Currently the fellow’s initial year consists of laboratory experience in the Departments of Cancer Biology or Cancer Pharmacology. The fellows have a one-year research experience under the direction of one of the senior investigators. This experience will be without interruptions related to clinical duties and during this year, the fellows complete required graduate course work in biostatistics and molecular biology. The research experience will allow an intensive study into the scientific basis for current and future cancer care. It is anticipated that the fellows will supplement the initial research experience with additional research projects during the later two years of the fellowship.

Quality counts when referring patients to hospitals and physicians. Designed for a healthcare provider audience, the Outcomes books contain a summary of our surgical and medical trends and approaches, data on patient volume and outcomes, and a review of new technologies and innovations.

The Gynecologic Oncology fellows benefit from a strong clinical program marked by high quality and complex patient care provided in a setting noted for collaboration and collegiality. The hallmark of Cleveland Clinic has been the excellence of its patient care that has largely developed as a result of the collegial relationship among departments and individual clinicians. The large volume of patient cases provided enables the fellows to have a broad based exposure to clinical gynecologic oncology marked by progressive responsibility in both the outpatient clinic and the hospital. In addition to clinical responsibility, it is expected that trainees will also progress in their abilities to conduct independent research, teaching of residents and medical students as well as administrative duties. The program director and other faculty will be regularly meeting with the fellows to assess their progress in these goals so that individual weaknesses can be identified, remedied and increased responsibility assumed.

During the time of your Gynecologic Oncology Fellowship your rotations will include:

18 months Gynecology Oncology

1 month Radiation Oncology

1 month Surgical Intensive Care Unit

1 month Palliative Medicine

2 months chemotherapy

12 months research

1 month elective time

Chemotherapy

The gynecologic chemotherapy service is a fully integrated portion of the Gynecologic Oncology program at all sites. In addition to the gynecologic oncologists, it is staffed by expert gynecologic nurse clinicians. When possible, patients are treated on National Cooperative Group clinical trials as well as in house studies. Major decisions resulting in surgery, radiation therapy or a change in chemotherapy regimens are frequently integrated into the outpatient clinics when the fellows are participating.

Minimally Invasive Surgery Center

In addition to an intensive exposure to conventional procedures for gynecologic malignancies, the fellows have an opportunity to participate in the development and application of endoscopic approaches to gynecologic cancers. The Minimally Invasive Surgery Center at this institution has attracted world-class individuals including Dr. Tommaso Falcone (Chairman of Obstetrics, Gynecology and Women’s Health Institute). The Minimally Invasive Surgery Center allows the fellows to participate in surgical innovation, research, and new technology related to gynecologic oncology, including robotic surgery, single-port laparoscopy and robotic single-port surgery. A series of strong and stimulating off-service rotations have been arranged. These experiences will offer the fellows an intensive exposure to allied disciplines with the opportunity to work with experienced clinicians on very active services

Outpatient Clinics

All members of the team will participate in the outpatient clinics throughout both clinical years. Initial examination is performed by the fellow and then subsequently supervised by the individual faculty member who has received the referral. An effort is made to involve the fellows in new patient assessment whenever they are available. Management decisions and plans are then collectively reviewed and implemented. Other outpatient activities will be as time allows given the fellow’s responsibilities in the hospital/operating room. However, the fellows are aware that we expect outpatient clinic participation when possible as we believe it is critical to their training.

Research Expectations

The first year of fellowship consists of a protected 12-month research experience. During this time, the fellows are without weekday clinical responsibilities, but may be required to cover night or weekend call during the year. Laboratory projects will be carried out in the Research Institute. There is a wide range of research opportunities available including focusing on molecular genetic analysis of common human malignancies, studying ovarian cancer growth factors and tumor markers (in particular the area of bioactive lysophospholipids), work on interferons, tumor suppression, innate immunity, antisense and apoptosis, molecular mechanisms of initiation and progression of carcinogenesis, and studying molecular mechanisms controlling cellular responses to extra cellular stimuli. While it is anticipated that the fellow will complete their primary project during their first year of fellowship, opportunities for continued interfacing with the research division fellows and laboratory personnel is encouraged to allow additional experience and maturation of projects. Opportunities for non-laboratory, prospective clinical research projects will also be considered individually for those fellows desiring more clinical or epidemiological research experiences. Several of our fellows have completed cancer screening projects in underserved countries over the last five years with Dr. Jerome Belinson (Consultant Staff in Gynecologic Oncology).

Teaching Opportunities

The fellow will have the opportunity to enhance their individual teaching skills. There will be at all times residents from either the integrated Cleveland Clinic/MetroHealth Medical Center Residency Program or the newly approved Cleveland Clinic Residency Program. A second and fourth year resident is assigned full time to the oncology service. We also have the “Gruber Fellowship” which allows visiting 3rd year Ob/Gyn residents to have a more intensive experience on our service, often leading towards application for fellowship training. Medical student participation on the Gynecologic Oncology Service consists of third year clerks from Cleveland Clinic Lerner College of Medicine (CCLCM) or Case Western Reserve University School of Medicine (CWRU), and fourth year elective students from other institutions. The fellows also have many other educational opportunities for the teaching of allied medical personnel and nursing staff.

Departmental Ground Rounds

The Gynecology Oncology fellows will participate in weekly Departmental Grand Rounds. Included in these conferences are monthly Quality Assurance and Improvement meetings. The oncology fellows actively participate in these conferences and present all pertinent patient materials related to oncology patients. Additionally, the fellows are required to present the results of their research on an annual basis at Departmental Ground Rounds.

Conferences

Pathology Conference

The fellow will participate in weekly Gynecologic Oncology Pathology Conferences. During these conferences, one of the gynecologic pathologists reviews the histopathologic materials of all recent patients. Additionally, the fellow will lead the weekly Gynecologic Oncology Patient Management Conference during which all hospital patients and their planned therapies are reviewed with the faculty and other personnel. Recognizing the strength we have in gynecologic pathology (currently five Gyn Pathologists) and the Pathology Department’s sub-specialty sign-out of surgical specimens, we place a strong emphasis on pathology review and its integration into clinical management. The fellows as well as other trainees are responsible for the presentation of new patients at the weekly conferences and proposed programs of management will be presented and defended.

Fellowship Didactics

The didactic course for the fellows is a blend of methods to include fellow presentations, cases discussions, didactic lectures, and core based learning. The course materials are assembled into a useful resource for boards, with the current plan being a collection of CDs.

Medical Oncology Seminars

The Gynecologic Oncology fellows are encouraged, as time permits, to attend the relevant seminars at the Lerner Research Institute as well as the Medical Oncology Seminar Series. These programs are offered throughout the academic year. The initial three months of medical oncology seminars are intended as an overview of oncology for new medical oncology fellows and first year Gynecologic Oncology fellow(s) will be encouraged to attend. Approximately six times per year a combined Cleveland Clinic/CWRU Journal Club occurs. Each fellow presents and reviews an article of current interest with the focus on a specific topic

Through the generous support of Mr. and Mrs. Tom Gruber, visiting rotations of one month are offered to individuals considering a career in Gynecologic Oncology or wishing to expand their clinical experience. Selected residents, from ACGME approved residencies, will work with the Gynecologic Oncology team to care for patients with complex and diverse gynecologic cancers. Participation will involve hospital/OR responsibilities and outpatient and chemotherapy clinic participation. Regular conference and didactic presentations are offered.

Participants can expect enhanced surgical experience and an improved understanding and exposure to the discipline of Gynecologic Oncology.

Residents in ACGME approved programs entering their PGY3 year are invited to apply. Visiting residents will have access to all facilities and support in the Cleveland Clinic Division of Education. Round-trip transportation expenses, a furnished apartment close to Cleveland Clinic and a monthly stipend will be provided. Malpractice insurance must be provided by the home institution.

How to Apply

Gruber Visiting Fellowship

Physician who are eligible to apply will be completing a four-year residency program in obstetrics and gynecology accredited by the Accreditation Council for Graduate Medical Education in the United States or a five-year residency program in Canada accredited by the Royal College of Physicians and Surgeons of Canada.

The application deadline is May 1 of the preceding academic year.

Applicants also must be eligible to take the American Board of Obstetrics and Gynecology (ABOG) written examination.

The Gynecologic Oncology Fellowship offers a rotation of 1-2-1categorical positions . All positions are filled through the National Residency Matching Program (NRMP) match. International applicants are invited to apply through the NRMP as well.

How to Apply

The Gynecologic Oncology Fellowship participates in the Electronic Residency Application Service (ERAS) for all positions. Our application requirements are the same as the standard ERAS application:

Complete Application

CV

Personal Statement

Medical Student Performance Evaluation (MSPE)

Medical School Transcript

USMLE Step I USMLE Step 2 Three Letters of Recommendation (One of which has to be from your residency program director)

Deadline

Gynecologic Oncology application deadline:

Deadline for interview applications is May 1, 2015. Applications should be submitted through the ERAS system. Interviews will be July 9 and July 10, 2015. Invitations to be interviewed will be emailed.

Interviews

Offers for interviews will be made via email starting in June. If invited for an interview, please plan on being here all day. In most cases, interviews will be completed by 4 p.m. Applicants are invited and highly encouraged to attend a social dinner the night before with our current fellows. Detailed information regarding the actual interview day, traveling to Cleveland, hotel accommodations, etc. will be provided to the applicant once the interview is confirmed.